Comparison of the effect of GnRH agonist dosage in girls with central precocious puberty

Jang, Shinyoung; Kim, Su Jin; Lee, Myeongseob; Lee, Hae In; Kwon, Ahreum; Suh, Junghwan; Song, Kyungchul; Chae, Hyun Wook; Kim, Ho-Seong

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Original article

DOI: https://doi.org/10.6065/apem.2244210.105 [Accepted] Published online February 3, 2023.

Comparison of the effect of GnRH agonist dosage in girls with central precocious puberty

Shinyoung Jang¹, Su Jin Kim¹, Myeongseob Lee¹, Hae In Lee², Ahreum Kwon¹, Junghwan Suh¹, Kyungchul Song¹, Hyun Wook Chae¹, Ho-Seong Kim¹

¹Department of Pediatrics, Division of Pediatric Endocrinology, Severance Children
²Department of Pediatrics, Gangnam Cha Hospital, Cha University School of Medicine, Pocheon, Korea

Address for correspondence: Ho-Seong Kim
Email: kimho@yuhs.ac

Received: September 2, 2022 Revised: October 18, 2022 Accepted: October 27, 2022

Abstract

Purpose
There are no definite guidelines on the optimal dosage of gonadotropin-releasing hormone (GnRH) agonist for treatment of central precocious puberty (CPP). We compared growth outcomes of GnRH agonist at different dosages in girls with idiopathic CPP to assess the optimal dosage.
Methods
This retrospective study included 86 girls with idiopathic CPP who had been treated with GnRH agonist at least for 1 year and had attained their final adult height. Leuprolide was given as fixed dosage (3.75 mg every 4 weeks in body weight >20 kg, n=72) or weight-based dosage (60-85 μg/kg every 4 weeks, n=14). We compared suppression of advanced puberty and treatment response between the two groups.
Results
Peak estradiol and luteinizing hormone and bone age (BA)/chronological age (CA) after injection of GnRH agonist were effectively suppressed in both groups. In both groups, the height standard deviation score (SDS) for BA increased after treatment. Final adult height (FAH) (fixed dosage group,160.8±4.1 cm and weight-based dosage group, 161.2±4.4 cm) was significantly higher than the initial predicted adult height (PAH) (155.5±3.3 and 156.1±3.6 cm, respectively) (both P<0.001) and similar to midparental height (159.8±3.3 and 160.6±3.7 cm, respectively). There were no differences in gain in height SDS for BA and gain in height (FAH-PAH at the start) between the two groups.
Conclusion
There were no differences in treatment outcome between fixed dosage (3.75 mg/4 wks) and weight-based dosage (60~85μg/kg/4wks) of GnRH agonist. Therefore, fixed dosage of GnRH agonist can be used more conveniently for CPP treatment without growth over-suppression.

Keywords: GnRH agonist, Administration and dosage, Precocious puberty, Treatment outcome

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